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4th Year Semester 1 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Esophagus length?

A

25-30 cm

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2
Q

Esophagus diameter?

A

2-3 cm

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3
Q

From upper central incisors to upper esophageal sphincter length?

A

15 cm in adult

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4
Q

Cervical esophagus?

A

C6 to T4

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5
Q

Thoracic esophagus?

A

T4 to T10

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6
Q

Abdominal esophagus?

A

T10 to T11

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7
Q

Manometry of esophagus?

A

Contractions of muscles

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8
Q

Impedancemetry of esophagus? معاوقة

A

Function - GERD - Air solid liquid

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9
Q

Provocative Tests?

A

Bernstein test - Tensilon test - Balloon distention test

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10
Q

البلع المؤلم in English

A

Odynophagia

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11
Q

Zenker diverticula?

A

Pulsion, upper 3rd, posterior wall, males more, both sex, +50 years, angry

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12
Q

Type I HH?

A

Sliding HH, most common, reflux disease, cardia and Z line up

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13
Q

Type II HH?

A

Rolling HH, fundus, cardia & Z line normal, (paraesophageal hiatus, gerd, mechanical complications)

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14
Q

Type III HH?

A

Mixed type I + II
(paraesophageal hiatus, gerd, mechanical complications)

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15
Q

Type IV HH?

A

Esophagohiatal membrane, visceral organs up, (paraesophageal hiatus, gerd, mechanical complications)

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16
Q

SAINT syndrome?

A

HH
Gallstones
Colic diverticulum

صدفة

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17
Q

Ciprofloxacin?

A
  • is a fluoroquinolone antibiotic
  • to treat a number of bacterial infections
  • bone and joint infections
  • intra abdominal infections
  • certain types of infectious diarrhea
  • respiratory tract infections
  • skin infections
  • typhoid fever
  • urinary tract infections…
  • 2nd generation (…floxacin (2nd&3rd))
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18
Q

Flagyl?

A

Metronidazole (Flagyl)
Tinidazole
Nimorazole
Ornidazole
Secnidazole

  • antibiotic and antiprotozoal medication
  • pelvic inflammatory disease
  • endocarditis
  • dracunculiasis
  • giardiasis
  • trichomoniasis
  • amebiasis
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19
Q

Infliximab?

A
  • a chimeric monoclonal antibody
  • brand name: Remicade
  • treat a number of autoimmune diseases : Crohn’s disease - ulcerative colitis - rheumatoid arthritis - ankylosing spondylitis - psoriasis - psoriatic arthritis - Behçet’s disease
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20
Q

Pain after 10 min from eating?

A

Stomach / Colon

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21
Q

Pain after 2 hours from eating?

A

Duodenum

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22
Q

Pain after 0.5-1 hour from eating?

A

Gall bladder

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23
Q

Obstructive jaundice?

A
  • Old people
  • Ampulla of Vater (leads to anemia)
  • Repeating yellowish color
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24
Q

Best way to examine pancreas?

A

CT scan

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25
Q

Best way to examine bile ducts?

A

MRCP

Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct.

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26
Q

Best way to examine common bile duct?

A

EUS

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27
Q

Bile stones origin?

A

80% gall bladder
20% bile ducts

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28
Q

Vomit after 1/4 hour?

A

Stomach pyloric stenosis

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29
Q

ماذا نشاهد في تأمل البطن؟

A
  • الحجم
  • التناظر
  • السرة
  • آثار جراحة
  • دوران جانبي
  • حبن
  • متنفس؟
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30
Q

DD of diarrhea?

A
  • stomach/intestines inflammation
  • pharmaceutical
  • hyperthyroidism
  • diabetes in late stages
  • ulcerative colitis 100٪ يصيب المستقيم + زحير دائم
  • Crohn’s disease يصيب كل طبقات الامعاء
  • malabsorption
  • colon spasm
  • colon tumors
  • tuberculosis
  • bacterial
  • parasitic
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31
Q

Colonoscopy limitation w.r.t Hb?

A

Hb<7

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32
Q

Normal MCV?

A

80-100

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33
Q

Normal Urea?

A

20-50

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34
Q

Normal CRP?

A

1-5

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35
Q

Normal Na?

A

135-145 mEq/L

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36
Q

Normal K?

A

3.5-5.5

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37
Q

Normal Plt?

A

150,000 to 450,000 platelets per microliter of blood

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38
Q

Mesacol?

A
  • Mesalazine = Mesacol = mesalamine = 5-aminosalicylic acid
  • treat inflammatory bowel disease (ulcerative colitis, Crohn’s disease)
  • mild to moderate severe disease
  • oral/rectal
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39
Q

Azathioprine (Imuran)?

A
  • immunosuppressive medication
  • rheumatoid arthritis
  • granulomatosis with polyangiitis
  • Crohn’s disease
  • ulcerative colitis
  • systemic lupus erythematosus
  • kidney transplants to prevent rejection
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40
Q

Crohn Disease Activity Index (CDAI): 0-149 points?

A

0 to 149 points: Asymptomatic remission

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41
Q

Crohn Disease Activity Index (CDAI): 150-220 points?

A

150 to 220 points: Mildly to moderately active Crohn’s disease

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42
Q

Crohn Disease Activity Index (CDAI): 221-450 points?

A

221 to 450 points: Moderately to severely active Crohn’s disease

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43
Q

Crohn Disease Activity Index (CDAI): 451-1100 points?

A

451 to 1100 points: Severely active to fulminant disease

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44
Q

Platelet high count causes?

A
  • David syndrome
  • hemorrhage
  • iron deficiency anemia
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45
Q

Best way to examine a patient’s nutritional status?

A

Albumin

(pre-albumin for acute malnutrition)

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46
Q

أي مريض بهجمة IBD

A

تمييع

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47
Q

كبر حجم البطن DD؟

A

1 - obesity

#2 - gases
#3 - pregnant
#4 - ascites
#5 - tumors
#6 - chronic neurogenic bladder

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48
Q

ألم شرسوفي يخف بالانحناء للامام؟

A

بنكرياس

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49
Q

زحير = مشكلة في ال؟

A

مستقيم

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50
Q

صدر برميلي يوجه ل؟

A

توسع قصبات
COPD

51
Q

ALP sources?

A
  • bone
  • intestines wall
  • placenta
  • liver
  • bile ducts
52
Q

حواف مشرشرة للكبد توجه نحو؟

A
  • cirrhosis
  • metastatic liver
53
Q

Normal PVD (portal vein diameter)?

54
Q

Ascites symptoms?

A

1 - ↗️ abdomen size

#2 - continuous generalized pain
#3 - early satiety
#4 - liquid leakage to pleural space
#4 - dyspnea
#5 - nausea

55
Q

Normal IJV diameter (internal jugular vein)?

A

9.1–10.2 mm

56
Q

Normal number of times going to bathroom?

A

3 times/day - 3 times/week

57
Q

Spleen normal length?

58
Q

Normal EF (ejection fraction)?

59
Q

Normal blood albumin?

A

3.4-5.4 g/dL

60
Q

Normal blood creatinine?

A

0.7 to 1.3 mg/dL for men
0.6 to 1.1 mg/dL for women.

61
Q

Normal blood LDH?

A

140 U/L to 280 U/L for adultsand tend to be higher for children and teens

62
Q

Normal blood TP (total protein)?

A

6.0 to 8.3 g/dL

63
Q

Penicillamine?

A
  • Penicillamine (Cuprimine)
  • Wilson’s disease treatment
  • Kidney stones and high urine cystine levels
  • Rheumatoid arthritis
  • various heavy metal poisonings
  • Taken by mouth
64
Q

Zinc relation with insulin?

A
  • Stimulates insulin action and insulin receptor tyrosine kinase activity
  • People with diabetes have been known to have more zinc in their urine and less in their bloodstream
  • Higher zinc levels in blood are linked to a lower risk of diabetes.
65
Q

Most common site of PUD

A

Stomach & 12

66
Q

Most commin cause for PUD

A

HP & NSAIDs (95%)

67
Q

ماذا تفرز ECL بالمعدة

A

Ach

Gastrine

Histamine

68
Q

ماذا يحفز مضخة البروتون والخلايا الجدارية على العمل

A

Ach

Gastrine

Histamine

69
Q

ماذا تفرز خلايا Chief

A

Pepsinogen

الذي يتحول الى pepsin بفعل HCl

70
Q

اين تعيش HP

A

في مخاطية من نمط معدي فقط

  • حؤوول في 12
  • حؤول في المري
  • رتج ميكل في الامعاء الدقيقة
71
Q

كيف تحمي HP نفسها من حمض المعدة

A

فعالية اليورياز
Urea ➡️ Ammonia

الفعالية الحركية

72
Q

ماذا يفيد التخلص من HP

A

يزيل القرحات المعدية والعفجية ويمنع النكس

73
Q

ماهي بعض الذيفانات التي تفرزها بعض انواع HP

A
  • Cag A : cytotoxin accociated gene
  • Vac A : vaculating accociated gene
74
Q

PUD symptoms

A

Sometimes no symptoms

Dyspepsia

Hemmorhage - perforation - blockage

Heartburn

75
Q

NSAIDs effect on COX 1

A

decreased blood flow which leads to mucosal injury

76
Q

NSAIDs effect on COX 2

A

Increased neutrophil adherence which leads to mucosal injury

77
Q

NSAIDs effect on topical imitation

A

Epithelial damage which leads to mucosal injury

78
Q

NSAIDs side effects on GIT

A

نزف تحت مخاطية

تسحجات

قرحات

79
Q

NSAIDs risk factors for PUD

A

age > 60 years

First 30-90 days of NSAIDs treatment

Past history

HP

Use with steroids, anti-platelet drugs, or anti-coagulant drugs

80
Q

Other causes for PUD

A

Zollinger-Ellison disease

Mastocytosis (↗️ histamine)

CML (↗️ histamine)

After Billroth II

SI removal

Syphilis - Tb …

81
Q

Smoking and PUD

A

More common

More complications

↗️ need for surgery

↘️ treatment duration

↗️ recurrance rate

82
Q

Alcohol and PUD

A

Injury on mucus

↗️ HCl secretion

لا يوجد دليل قوي انه عامل خطر

83
Q

هل تكفي الحمية والنمط الغذائي او العوامل التفسية لتسبب PUD

A

لا يوجد علاقة

84
Q

Comparison of gastric and 12 ulcers

A

Gastric:
- directly after food
- ↗️ pain after eating
- do not wake up
- +/- ↘️ weight
- vomit is common
- can become cancerous

Duodenal:
- after 4 hours from food
- ↘️ pain after eating
- wake up
- +/- ↗️ weight
- vomit is uncommon

Both lead to hemmorhage, perforation, blockage

85
Q

Favourite diagnosis of PUD

86
Q

Treatment of PUD

A

1 - PPIs

(Anti H2)

Associated with antibiotics

For 10 to 14 days

87
Q

Gastric neoplasms?

A

Benign : epithelial - mesenchymal

Malignant : primary (adenocarcinoma 95% - lymphoma 5% - GIST <5%) - secondary (#1-Breast #2-Melanoma #3-Colon)

88
Q

Gastric adenocarcinoma?

A

3 most lethal neoplasm

50 - 70 YO

Males+

More aggressive in young

Dyspepsia symptoms

55YO male living in Japan working in industry

89
Q

Environmental RF for stomach carcinoma

A

HP

Diet (↗️ salt ↘️fruits & vegetables)

↘️ Socio-economic status

90
Q

Genetic RF for stomach carcinoma

A

Family history

P53 / BRCA2

Familial adenomatous polyposis (FAP)

hereditary non-polyposis colorectal cancer (HNPCC) (Lynch syndrome)

91
Q

Predisposing RF of stomach carcinoma

A

Pernicious anemia

Chronic PUD

Smoke

Alcohol

Atrophic gastritis

Gastric polyps

Previous gastric resections

92
Q

Signs of gastric adenocarcinoma

A

Anemia

↘️Weight

Epigastric mass

Hepatomegaly

Ascites

Jaundice

Blumer shelf

Virchow’s jode (left)
Irish node (left)

Sister Mary Joseph nodule

Krukenberg tumor (ovaries)

اورام المعدة والكبد متحركة بالتنفس

93
Q

Proximal vs Distal stomach cancer

A

Cardia/Fundus - Antrum

More - less

Diffuse↗️ - intestinal↗️

Females↗️ - Males↗️

Younger↗️ - older↗️

More aggressive - less aggressive

Developed countries - poor countries

HP X - HP↗️

GERD

94
Q

Spread of gastric carcinoma

95
Q

Adenocarcinoma investigation

A

1-Endoscopy: gold - safe - biopsies - 98% diagnosis - PUD 25% - Polyp 25%

Double contrast study

CT Scan (metastases)

MRI / US (wall thickness)

EUS : diagnosis in Radial - Biopsies in Linear - DEPTH

96
Q

Management of stomach adenocarcinoma

97
Q

Gastric Lymphoma

A

20% of all extranodal lymphomas

Late YO

Males +

Two types:
#1-DLBCL: 55%
#2-ENMZL: Maltoma - 40% - HP - NH-lymphoma

98
Q

GIST?

A

Cajal cells

Muscular layer

Stomach

Asymptomatic

CD117 (KIT)

non-epithelial +

63-69 YO

Diag: Endoscopy (biopsies not enough) - EUS - CT

Mitotic index > 5 per 50 HPF

Treat: surgery

99
Q

تطور الجيوب

A

الشهر 3 - 4 fetal : يبدأ تشكل الجيوب

عند الولادة : فكي + خلايا غربالية

3 سنوات : وتدي

5-7 سنوات : جبهي

18 - 20 سنة : اكتمال نمو الجيوب

100
Q

يصب في الصماخ المتوسط

A

فكي

جبهي

غربالية امامية

101
Q

تشخيص الفتق الحجابي

A

تنظير هضمي علوي

تصوير ظليل للمري (وضعية تراندلبرغ)

قياس ضغزط المري

قياس ph المري

102
Q

Metabolic associated fatty liver disease (MAFLD)

A

previously termed non-alcoholic fatty liver disease, is the leading global cause of liver disease and is fast becoming the most common indication for liver transplantation.

103
Q

لا ندخل الابرة بمكان…

A
  • طبلية
  • فيه التهاب
104
Q

دائماً نطلب في حال بزل سائل؟..

A
  1. لون + حجم السائل + المشاهدة والاجراء
  2. Chemistry
    Glucose Alb Tp Chol CRP
  3. Cbc
  4. تحري خلايا شاذة
  5. دراسة جرثومية
105
Q

Cirrhosis ↗️↗️↗️ ALP

A

قد يكون آفة شاغلة للحيز مع التشمع

106
Q

اسباب نقص كريات حمر

A

نقص نتاج النقي

نزف أنبوب هضمي

قصر عمر كريات حمر

فرط توتر وريد باب

107
Q

طين مراري قد يكون في سياق..

A

الحبن ونقص alb

لا نحول لعمل جراحي

108
Q

سماكة جدار مرارة معممة

A

مريض ليس عالريق
↘️ Alb
بدء تشكل الحبن
كل التهابات الكبد خاصة HAV
بورسلانية
اندخالات كوليسترانية بجدار المرارة
التهاب مرارة مزمن
التهاب مرارة حاد

109
Q

Afp

A

ورم خصية
اكتر من 400 ورم كبد

كل تجدد كبدي يزداد افرازه
(و PSA)

110
Q

مدروج حبن عالي :

A

غالباً آلية فرط توتر وريد الباب

111
Q

Groove pancreatitis

A
  • rare form of chronic pancreatitis
  • affecting the “groove” between the pancreatic head, duodenum, and common bile duct
  • unknown, although there are strong associations with long-term alcohol abuse, functional obstruction of the duct of Santorini, and Brunner gland hyperplasia
  • 50-60 YO
112
Q

Alb serum - Alb ascites =?

A

<1.1 فرط توتر وريد باب عالي مدروج

> 1.1 حدثية التهابية جوف بريتوان منخفض مدروج

113
Q

Common bile duct diameter

A

7 normal

up to 11 mm
(But normal liver tests)

Every 10 years + 1mm

114
Q

AST higher than ALT?

A

Alcoholism

Wilson

A. I.

Cirrhosis

Drugs

115
Q

فرط توتر وريد باب

A

دوران جانبي

حبن

دوالي

ضخامة طحالية

116
Q

قصور خلية كبدية

A
  • اظافر بيضاء
  • راحة حمراء
  • لون يرقاني
  • دنف
  • تثدي
  • اضطراب توزع اشعار
  • تبقرط
  • عنكبوت وعائي
  • وذمات طرفين سفليين
117
Q

Amlodipine?

A
  • sold under the brand name Norvasc
  • calcium channel blocker medication
  • used to treat high blood pressure and coronary artery disease.
  • taken by mouth
  • Common side effects include swelling, feeling tired, abdominal pain, and nausea.
118
Q

Nystatin A1?

A
  • sold under the brandname Mycostatin among others, is an antifungal medication.
  • used to treat Candida infections of the skin including diaper rash, thrush, esophageal candidiasis, and vaginal yeast infections.
  • may also be used to prevent candidiasis in those who are at high risk.
119
Q

Rituximab?

A

The chimeric anti-CD20 antibody rituximab induces apoptosis in B-cell chronic lymphocytic leukemia cells through a p38 mitogen activated protein-kinase-dependent mechanism.

Treat non-Hodgkin lymphoma

120
Q

Caldivit syrup

A

Caldivit syrup is used as bone joint supplement.It contains Calcium Carbonate ,Vitamin D3(cholecalciferol)Zinc Sulphate and Magnesium Hydroxide. Calcium carbonate is a mineral that is required for the formation of bones and maintaining them. Calcium carbonate is required to prevent breakage of bones.

121
Q

أين نشاهد قرحات قلاعية؟

A

IBD

داء بهجت

يرسينيا - شيغيلا - سالمونيلا - كامبيلوباكتر - اشريكية قولونية

CMV

122
Q

GAVE (Gastric antral venous ectasia) اين نشاهد

A

1 فرط توتر وريد باب

123
Q

Scleroderma on GIT?

A

نقص حركات قسم سفلي مريء

SIBO

امساك مزمن

رتوج +

ضمور عضلات ملساء

نقص تقلصية مرارة => حصيات

124
Q

علامات نقص K على ECG

A

تسطح P
تطاول PR
موجة منقلبة U

4th Year Semester 1 (7 decks)

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